Studying for the USMLE™ Step 1

What You Need to Know to Prepare

What is the USMLE Step 1 exam?

The USMLE® Step 1 (“The Boards”) is an important and extremely challenging exam that all new med students must take. It is the first in a series of three exams that comprise the United States Medical Licensing Examination, all of which students must pass in order to become a licensed physician in the United States.

Typically, the exam is taken once medical students have completed their foundational sciences in their second year, before their clerkships. However, some curricula are tailored in such a way that students take it after their clerkships.

The Step 1 exam is usually taken after your second year of med school, though this highly depends on your university’s curriculum. You can apply for it with the NBME (National Board of Medical Examiners) for a fee of $610 (as of 2018). The test is administered at any of several Prometric computer testing sites.

What’s exam day like?

Step 1 is a one-day exam. It is divided into seven 60-minute blocks and taken in one 8-hour testing session. Each block will usually not exceed 40 questions, and the entire exam will not exceed 280 questions.

Mastering time-management for exam day is almost as important as mastering Step 1 topics. The right study tool should train you not just to understand topics, but to draw from that knowledge quickly and effectively. When studying, try practicing on timed, exam-simulated USMLE interfaces to get a better feel for what you’ll experience on exam day.

What’s considered a good Step 1 score?

The exam is graded from a 1-300, with a minimum passing score being 194. Most scores fall between a wide range of 140-260; more detailed information on what your score means can be found in the USMLE Score Interpretation Guidelines. Students usually get their grade three to four weeks after the exam.

Should you fail the exam, you can take it again (up to six times), but do be aware that your failing grades could follow you through your career.

If you take the exam and aren’t happy with your grade, it’s not possible to take it again to raise your score.

What can I do to prepare for Step 1?

The Step 1 exam looms large for many medical students because it’s such a pivotal exam. How you perform on it will set the tone for the rest of your medical school career, and it is one of the most decisive factors considered by program directors when choosing applicants for a match to residency positions.

The pressure to do well can feel overwhelming. Students often have trouble dealing with what feels like too much information (about 2 years worth of materials!) and not enough time. Not to mention having to recall information learned very early on in your studies.

Getting exam-day-ready comes down to getting the right resources and tools. Budget for a few, high-quality resources that perform on multiple levels instead of shelling out for too many. You’ll want resources that can help you both cover a lot of ground and as well as get down to the details.

Ideally, the best resource you can find will offer a combination of the following features:

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The United States Medical Licensing Examination (USMLE™) is a joint program of the Federation of State Medical Boards (FSMB®) and National Board of Medical Examiners (NBME®). None of the trademark holders are affiliated with AMBOSS.